Fetal death due to extreme maternal Rh immune augmentation.
A 19-year-old woman who denied previous transfusion or pregnancy delivered a stillborn RhO(D)-positive male fetus at 38 weeks' gestation. IgG antibodies with the specificities anti-Rh0(D), anti-rh"(E), anti-Jka, and anti-Yta were eluted from the fetal red blood cells. In the maternal serum, the antiglobulin titer of anti-Rh0(D) was 1:20,000 and the saline (IgM) titer was 1:1,024. Amniocentesis findings at 36 weeks had suggested only mild, if any, fetal hemolysis, but the stillborn infant showed signs of severe hemolytic disease with cardiac failure. This case appears to represent an unusual augmented immune response to fetal red blood cell antigens.
D000328:Adult; D004899:Erythroblastosis, Fetal / Q000150:complications*; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D006801:Humans; D011247:Pregnancy; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D065227:Transfusion Reaction
D012204:Rh-Hr Blood-Group System